§ Mr. Win GriffithsTo ask the Secretary of State for Health what estimate he has made of the number of dentists that need to be trained in England to ensure(a) the maintenance of the present level of service and (b) that his dental health targets are met. [75438]
§ Mr. DenhamOn 31 March 1998 there were 19,711 dentists practising in the National Health Service in Great Britain, an increase of 2.6 per cent. on the year before. Numbers of dental students are also at a record level. In the 1997–98 academic year there were 3,929 undergraduate dental students in medical schools, an increase of 2 per cent. on the 1996–97 year.
A sub-group of the Dental Advisory Group on Medical Education and Training, which has been established to consider future workforce requirements, will hold its first meeting on 10 June 1999. Its discussions will be informed by our forthcoming dental strategy.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what assessment he has made of the need for facilities for dento-alveolar surgery. [75442]
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§ Mr. DenhamDento-alveolar surgery is mostly carried out within the facilities of primary dental care. Dento-alveolar surgery requiring more specialist Average time for referral treatment is provided by the hospital dental services. It is for health authorities to assess local need for such facilities.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what assessment he has made of the cost of clinical waste collection and water service charges to general dental practices; to what extent these costs are accounted for in the payments made to dentists for NHS work; and what plans he has to make changes in the reimbursement of dentists for these particular costs. [75437]
§ Mr. DenhamInformation on the cost of clinical waste collection and water service charges is not available centrally. As independent contractors, general dental practitioners are responsible for meeting all their own practice expenses. The fees payable to general dental practitioners reflect this fact. We have no plans to change this at present.
§ Mr. Win GriffithsTo ask the Secretary of State for Health how many treatments requiring prior approval from the Dental Practice Board were submitted in each of the last three years; how many were refused; and what was the(a) shortest, (b) longest and (c) average time taken to consider these requests. [75435]
§ Mr. DenhamThe number of prior approvals received by the Dental Practice Board which cover England, Wales and the Isle of Man and the number of these referred for investigation is given in the table.
Prior approval applications Number referred 1995–96 548,753 not available 1996–97 548,741 33,126 1997–98 554,584 49,833 The number of applications referred in 1995–96 is not available. The shortest time of dealing with the applications was one day.
Longest time for approval—referral not required Year Days 1995–96 38 1996–97 35 1997–98 45
Longest time for referral Year Days 1995–96 not available 1996–97 138 1997–98 124 560W
Average time for approval—referral not required Year Days 1995–96 5 1996–97 6 1997–98 5
Average time for referral Year Days 1995–96 not available 1996–97 85 1997–98 97
§ Mr. Win GriffithsTo ask the Secretary of State for Health (1) what estimate he has made of the number of dentists required in each health authority to provide a satisfactory level of service; [75439]
(2) if he will make a statement about (a) the availability of dental services in rural areas and (b) the steps being taken to improve access to dentists in rural areas. [75426]
§ Mr. DenhamHealth authorities have responsibility for monitoring the oral health and general dental services (GDS) in their area. If a health authority is concerned about the level of GDS provision in its area, it may ask the Secretary of State for Health to use his powers under Section 56 of the NHS Act 1977, to approve the funding of proposals submitted under the Investing in Dentistry initiative, which we launched in September 1997, or, where appropriate, seek approval to employ a salaried dentist(s).
The Personal Dental Services scheme (PDS) was set up under the NHS (Primary Care) Act 1997 to address local service problems and tailor services to meet local need, including in rural areas. PDS enables dentists and National Health Service trusts, working with health authorities, to develop and pilot new ways of delivering NHS dentistry. The first wave of pilot schemes began in October 1998.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what was(a) the public expenditure estimate and (b) the cost outturn for general dental services in England in 1997–98. [75427]
§ Mr. DenhamGeneral Dental Services (GDS) is not cash limited, so there is no set annual budget. The original vote provision and final expenditure in the GDS in England is shown in the table.
General Dental Service:1997–98 Expenditure £ million England Gross expenditure Net expenditure Provision made in main estimate 1,405.8 1,021.5 Outturn 1,349.3 959.1 Gross expenditure includes all fees and allowances payable to general dental practitioners, which cover their income and practice expenses, together with supplementary cost such as employers' superannuation contributions, payments of salaried dentists who provide GDS care in certain localities, and refunds to patients who incorrectly paid dental charges. Net expenditure shows costs after taking into account all dental charges collected from patients.
§ Mr. Win GriffithsTo ask the Secretary of State for Health if he will make a statement about current audit and peer review projects for general dental practitioners, 561W setting out (a) his assessment of their effectiveness and value for money and (b) his future plans for such projects. [75430]
§ Mr. DenhamAs our consultation paper AFirst Class Service indicated, participation of doctors and dentists in clinical audit schemes is central to our strategy for improving the quality of health care. Local audit and peer review advisory panels assess dental schemes and those dentists who participate are required to prepare resumes of their experience. A recent analysis of a sample of these reports showed that 89 per cent. of dentists viewed the process positively and 63 per cent. had acquired knowledge with a direct, beneficial impact on patient care. We have allocated £1.5 million for these schemes in 1999–2000 and have no plans to change the current arrangements.
§ Mr. Win GriffithsTo ask the Secretary of State for Health (1) if he will list by health authority area the average number of dental registrations per dentist; if he will make a statement on the impact on dental health of differences in the average number; and what measures are being taken to reduce such differences; [75534]
(2) how many adults have been seen by dentists under NHS regulations in each health authority area in each of the last three years for which figures are available. [75533]
§ Mr. DenhamThe table gives, by health authority (HA), the number of registered dental patients on 31 January 1999 as compared to the number of General Dental Service (GDS) dentists at 31 December 1998. Differences in these numbers between HAs will reflect differences in the level of commitment of dentists to the GDS (lower registrations per dentist are likely to indicate a lower level of commitment to the GDS by the dentists involved) and other factors. Figures on the number of adult patients seen by GDS dentists are not available.
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General Dental Service: Number of patient registrations1 per dentisf2,3 by health authority England Health authorities England 1,363 Avon 1,184 Barking and Havering 1,390 Barnet 663 Barnsley 1,996 Bedfordshire 1,255 Berkshire 1,070 Bexley and Greenwich 1,237 Birmingham 1,626 Bradford 1,605 Brent and Harrow 1,036 Bromley 833 Buckinghamshire 985 Bury and Rochdale 1,610 Calderdale and Kirklees 1,786 Cambridge and Huntingdon 1,442 Camden and Islington 779 Cornwall and Isles of Scilly 1,351 County Durham 1,850 Coventry 1,615 Croydon 1,039 Doncaster 1,875 Dorset 1,425 Dudley 1,728 Ealing, Hammersmith and Hounslow 781 East Kent 1,284 563W
General Dental Service: Number of patient registrations1 per dentist2,3 by health authority England Health authorities East Lancashire 1,547 East London and The City 1,002 East Norfolk 1,400 East Riding 1,894 East Surrey 964 East Sussex, Brighton and Hove 1,192 East and North Hertfordshire 1,344 Enfield and Haringey 1,102 Gateshead and South Tyneside 1,514 Gloucestershire 974 Herefordshire 1,292 Hillingdon 1,274 Isle of Wight 1,540 Kensington, Chelsea and Westminster 555 Kingston and Richmond 793 Lambeth, Southwark and Lewisham 1,169 Leeds 1,380 Leicestershire 1,726 Lincolnshire 2,229 Liverpool 1,570 Manchester 1,192 Merton, Sutton and Wandsworth 974 Morecombe Bay 1,366 Newcastle and North Tyneside 1,490 North Cheshire 1,831 North Cumbria 1,472 North Derbyshire 1,588 North Essex 1,439 North Nottinghamshire 1,943 North Staffordshire 1,679 North West Anglia 1,498 North West Lancashire 1,578 North Yorkshire 1,433 North and East Devon 1,239 North and Mid Hampshire 1,380 Northamptonshire 1,983 Northumberland 1,527 Nottingham 1,604 Oxfordshire 967 Portsmouth and South East Hampshire 1,373 Redbridge and Waltham Forest 1,261 Rotherham 1,777 Salford and Trafford 1,584 Sandwell 1,620 Sefton 1,719 Sheffield 1,707 Shropshire 1,362 Solihull 1,343 Somerset 1,540 South Cheshire 1,333 South Derbyshire 1,591 South Essex 1,424 South Humber 2,051 South Lancashire 1,391 South Staffordshire 1,752 South and West Devon 1,251 Southampton and S W Hampshire 1,423 St. Helens and Knowsley 1,569 Stockport 1,571 Suffolk 1,703 Sunderland 1,926 Tees 1,791 Wakefield 2,033 Walsall 1,858 Warwickshire 1,368 West Hertfordshire 1,095 West Kent 1,108 West Pennine 1,685 West Surrey 980 West Sussex 1,164
General Dental Service: Number of patient registrations1 per dentist2,3 by health authority England Health authorities Wigan and Bolton 1,780 Wiltshire 1,164 Wirral 1,497 Wolverhampton 2,001 Worcestershire 1,447 1 Adult and child patients registered at 31 January 1999 2 Includes Principals, Assistant and Vocational Dental Practitioners at 31 December 1998 3 Excludes Community, Salaried and Hospital dentists
§ Mr. Win GriffithsTo ask the Secretary of State for Health in each of the last three years what percentage of all types of dental treatments was referred to a dental reference officer for scrutiny; and what percentage was declared to be(a) of poor quality and (b) invalid. [75433]
§ Mr. DenhamIn 1996–97 and 1997–98 about 0.5 per cent. and 0.6 per cent. respectively of courses of treatment scheduled for payment for England, Wales and the Isle of Man were referred to a dental reference office for scrutiny. Of those patients seen, the dental officer had a major or fundamental disagreement with the treatment in 1.75 per cent. of cases in 1996–97 and 1.37 per cent. of cases in 1997–98. Information for 1995–96 is not available. These percentages cover both poor quality and invalid treatments. The dental officer was unable to comment in 3 per cent. of cases seen in 1996–97 and 4 per cent. in 1997–98.
§ Mr. Win GriffithsTo ask the Secretary of State for Health how many dentists are employed by each NHS trust in their community dental services; how many children were treated in the last year for which figures are available in each trust; and how many treatments were made. [75440]
§ Mr. DenhamThe information requested has been placed in the Library.
Table 1 gives the number of child patients, aged 15 years and under, seen for treatment by the community dental service (CDS) by health authority (HA) in England during the financial year 1997–98. The activity for each Trust is allocated to the HA for which the work is carried out. Table 1 also includes information on the number of episodes of care for children aged 15 years or under. An episode of care is a series of face to face contacts with a member of the CDS to complete a treatment plan.
The number of CDS dentists on 30 September 1997 is given in Table 2 by HA in England based on the location of the NHS trusts.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what percentage of treatments requiring prior approval from the Dental Practice Board was submitted to dental reference officers for further examination in each of the last three years; what percentage was refused; and what was(a) the shortest, (b) the longest and (c) the average time taken to consider these submissions. [75434]
§ Mr. Denham6 per cent. of prior approval applications in England, Wales and the Isle of Man were referred to dental reference officers for further investigation in 1996–97 and 71 per cent. of these patients were seen, for564W example, 4 per cent. of the total number of applications. In 1997–98, 9 per cent. were investigated further and 56 per cent. of patients were seen, for example, 5 per cent. of the total number of applications. Information for 1995–96 is not available.
Of those patients seen in 1996–97, the dental officer had a fundamental disagreement with the treatment plan in 0.47 per cent. of cases and had a major disagreement in 4.72 per cent. of cases. For patients seen in 1997–98, there was a fundamental disagreement in 0.38 per cent. of cases and a major disagreement in 3.48 per cent. of cases. However, refusal to give approval takes place only after further consultation at the Dental Practice Board.
In 1996–97 the quickest approval was made in 45 days, the average time taken was 85 days and the longest time taken was 138 days. In 1997–98 the quickest approval was made in 46 days, the average time taken was 97 days and the longest time taken was 124 days.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what percentage of dentists' earnings was made up of non-NHS work in each of the last five years for which figures are available. [75313]
§ Mr. DenhamInformation on non-National Health Service dental earnings is not collected. However, an annual Inland Revenue Survey gives information on the total gross earnings (i.e. including both NHS and private work) of General Dental Service (GDS) dentists, allowing a comparison with total gross GDS earnings. This indicates that the percentage of GDS dentists' earnings made up of non-GDS work over the last five years has been in the order of:
- 1991–92: 4 per cent.
- 1992–93: 5 per cent.
- 1993–94: 10 per cent.
- 1994–95: 14 per cent.
- 1995–96 and 1996–97 combined about 25 per cent.
The percentage estimate for the combined year 1995–96 and 1996–97 is not on the same basis as the estimates for the earlier years. The total gross earnings were obtained from a special data collection covering non-associate dentists only and the accounting years eligible for inclusion in the survey were less restrictive.
§ Mr. Win GriffithsTo ask the Secretary of State for Health what assessment he has made of the value of dentists participating in information management and information technology programmes; and what plans he has to provide financial support for such in-service development. [75535]
§ Mr. Denham10,983 National Health Service general dental practitioners in England and Wales are already linked electronically to the Dental Practice Board (DPB). Grants of £900 are made by the DPB, when dentists first establish electronic links to them, to assist with the purchase of suitable computer systems.
The value of information management and technology for dentists is one of the issues that will be considered by the team appointed to carry out an evaluation of Personal Dental Services pilots.
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